Series 6: No Adrenal Gland Left Behind
Don’t let fluid in the abdomen throw you off! Follow the SAME SDEP Adrenal imaging guidelines utilizing these modifications. *As with scanning most organs in an ascites presentation, you will need to “scan around the edges” as this is where your organs will be.
Imaging the adrenals with ascites:
- Go VERY HIGH paralumbar, vertical probe, protect the dog from footprint poking with your fingers- the dog should only feel your hand.
- Slide down the aorta, twisting as you go to keep it long, all the way to the left renal artery as standard.
- Remember be gentle but use steady pressure as likely the dog is very uncomfortable.
- For the right adrenal, you will likely need to have the dog tilted at 45 degrees or use a trough and go very high paralumbar at the notch of the ribs to find the right kidney, or go intercostal.
- GET IT FLAT as you can, but often in large dogs with ascites it is difficult to get the right kidney to the top of the body wall.
Ascites. Mineralizing right adrenal mass extending into the CVC seen in short axis.
- Push gently and steadily as best you can with pressure, then drop the tail of the probe and look for your standard landmarks – CVC and aorta.
- Twist and tilt to bring them in long if needed, then fan through and look for the HYPERECHOIC PHRENIC VESSELS which will point you to the right adrenal.
- You can also try the standing position with these dogs, or roll them over with their legs facing away from you.
Remember: *Don't get hung up by the ascites, all of the organs are still there, just presented a bit differently.
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